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General NPI Number Information
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NPI Number | 1336111418
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Entity Type | Individual
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Provider Name | DAVID RUSSELL WARD AU.D.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 5005 PROSPECT AVE NE STE C
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4283
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Country | US
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Telephone | 505-295-1770
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Fax |
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Provider Business Mailing Address
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Address Line | 5005 PROSPECT AVE NE STE C
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4283
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Country | US
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Telephone | 505-295-1770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 80349
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License Number State | TX
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